A comprehensive guide designed to enable CBT practitioners to effectively engage people from diverse cultural backgrounds by applying culturally-sensitive therapeutic techniques
Adapts core CBT techniques including reattribution, normalization, explanation development, formulating, reality testing, inference chaining and resetting expectations
High profile author team includes specialists in culturally-sensitive CBT along with world-renowned pioneers in the application of CBT to serious mental illness
Contains the most up-to-date research on CBT in ethnic minority groups available
This book pulls all the current data on the effectiveness ofculturally sensitive CBT in this area as well as providingclinicians with a manual to learn and practice culturally informedCBT. I can confidently recommend it as helpful for anyone workingwith severely mentally ill clients.--Aaron T. Beck, M.D.,University Professor Emeritus of Psychiatry, University ofPennsylvania This volume offers a practical guide to culturally adapting CBTfor severe mental health conditions. The authors are giftedclinicians and investigators that present a sophisticated overviewof key conceptual and pragmatic issues in working with diversecommunities. The book proposes novel concepts and applications of awell-established evidenced-based treatment in which language,culture, race, and ethnicity, are integral to the conceptualizationand process of therapy. This book is a remarkablecontribution to the growing literature on cultural adaptations andas such it represents a major contribution to multiculturalpsychology and mental health. This is essential reading forclinicians and scholars interested in working with the diversemajority-world communities.--Guillermo Bernal, Ph.D.,Director, Institute for Psychological Research, University ofPuerto Rico, Rio Piedras, Puerto Rico. There was a time when psychological therapies were not thoughtto be appropriate for all patients, especially those of lowsocio-economic or poor educational status, and ethnic minorities,refugees, migrants or people from low and middle-income countries.Clinicians did not have the tools to adapt their skills. No more!Combining psychoanalytic, cognitive behavioural and generaltherapeutics theory with evidence on the cultural adaptation ofpsychological therapies, this impressive, accessible and timelyvolume offers hope to patients of diverse cultural heritage,beliefs, and practices.--Kamaldeep Bhui, Professorof Cultural Psychiatry & Epidemiology, Queen Mary University ofLondon In a globalized world we need methods to adapt interventions sothey are equally effective for different groups. One sizefits all and culture and color blind approaches hardwire inequity.Many have undertaken cultural adaptations but to have some of themajor voices in CBT produce guidance on cultural adaptationproduces a priceless treasure. Whether you are developingservices in a low income country or for marginalised groups in ahigh income country this book will help you produce the mosteffective CBT for the people you serve.--Kwame McKenzieM.D. FRCPsych (UK), Medical Director CAMH, Professor of PsychiatryUniversity of Toronto "With its clear, thoughtful prose and its diverse, vivid caseexamples, this guide will help CBT practitioners sensitively handlethe challenges of working with individuals and families from a widevariety of cultural, religious, and spiritual backgrounds. Byusing these approaches, unique and thorny challenges to the crosscultural application of CBT can be creatively and collaborativelyaddressed and resolved."--Ron Unger "Culturally informed mental health care is rapidly moving froman attitudinal orientation to an evidence-based approach. Thistextbook makes an important contribution towards understanding theconceptual basis and evidence behind cultural adaptation ofcognitive behavioral therapy, but also provides clinical andcontextual guidance in application for diverse populations andserious psychiatric disorders. A must-read for the clinician whowishes to serve the majority of patients we will be serving ascultural plurality is achieved in the US andglobally."--Andres J Pumariega, M.D., Professor and Chair,Cooper Medical School of Rowan University and Cooper HealthSystem
About the Authors vii
Foreword ix
Preface xi
Acknowledgements xiii
1 Introduction 1
2 Cultural Adaptation of Cognitive Behavioural Therapy: Principles and Challenges 14
3 Philosophical Orientation and Ethical and Service Considerations 46
4 The Therapeutic Relationship and Technical Adjustments 86
5 General Theoretical Modifications in Orienting Clients to Therapy 121
6 Individualized Case Formulation 135
7 Individualized Treatment Planning 165
8 Psychosis: Cultural Aspects of Presentation and Adaptations to Treatment 192
9 Depression: Cultural Aspects of Presentation and Adaptations to Treatment 227
10 Bipolar Affective Disorder: Cultural Aspects of Presentation and Adaptations to Treatment 248
11 Recovery, Relapse Prevention, and Finishing Therapy 273
12 Policy and Training Implications 293
Appendix
1 Social Factors: My Immigration Journey 306
2 Aida Longitudinal Formulation 308
3 Setting Goals to Improve Quality of Life 310
4 Voices Diary 312
5 What Do Voices Say? 314
6 Working on Coping Strategies: Pleasant Events Schedule 315
7 Preventing a Relapse or Breakdown 317
8 Circle of Support 320
9 Relapse Prevention Plans 322
Index 326
Dr Shanaya Rathod is a Consultant Psychiatrist, Clinical Services Director and Director of Research at Southern Health NHS Foundation Trust, UK. Dr Rathod has been a Fellow of the National Institute for Health and Care Excellence. She has published a number of papers in peer reviewed journals, book chapters, and books including,
Back to Life, Back to Normality: Cognitive Therapy, Recovery and Psychosis (2009).
David Kingdon is Professor of Mental Health Care Delivery at the University of Southampton, UK, and Honorary Consultant Adult Psychiatrist for Southern Health NHS Foundation Trust. He has previously worked as Medical Director for Nottingham Health Care Trust and Senior Medical Officer (Severe Mental Illness) in the UK Department of Health. He now does policy and implementation work for NHS England and is editor of their mental health websites.
Dr Narsimha R Pinninti is Professor of Psychiatry at the Rowan University School of Osteopathic Medicine and Chief Medical Officer for Twin Oaks Community Services in New Jersey, USA. A certified cognitive therapist and psychiatrist for the Assertive Community Treatment Team, Dr Pinninti has published over 40 articles in peer reviewed journals and authored two manuals on how to teach Cognitive Behavioural Therapy interventions for case managers and clients.
Douglas Turkington is Professor of Psychosocial Psychiatry at Newcastle University, UK. Professor Turkington is an expert on the efficacy and effectiveness of cognitive behavioural therapy (CBT) in the treatment of schizophrenia. A fellow of the Royal College of Psychiatrists and founding fellow of the Faculty of Cognitive Therapy in Philadelphia, he has written more than 100 articles on the subject of CBT in schizophrenia.
Dr Peter Phiri, PhD is a Cognitive Behaviour Therapy Specialist and Research & Development Manager (Interim) at Southern Health NHS Foundation Trust and Honorary Lecturer at the University of Southampton, UK. He is an accredited member of the British Association of Behavioural and Cognitive Psychotherapy.
Although proven as one of the most effective evidence–based therapies, a key criticism of the theoretical framework of CBT is that it is Eurocentric, and therefore an ineffective tool for treating people from diverse cultural backgrounds. As a result, people from ethnic minority groups are often reluctant to work with therapists, who in turn do not feel confident in their ability to work effectively with them.
This book is designed to enable CBT clinicians to engage people from diverse cultural backgrounds by adapting their therapeutic techniques, resulting in increased therapist confidence and much improved patient outcomes. It explores the cultural norms and expectations of groups including African Caribbean, African American, Chinese, Latino, Indian and South Asian Muslim, considering attitudes to mental illness, the role of family and wider community, and cultural barriers to engaging with therapy. Featuring an array of clinical case studies along with coverage of the most up–to–date data from CBT research in ethnic minority groups, this is an essential new resource for anyone studying or practicing CBT.